Coping with Pandemic Losses: Recognizing & responding to signs of our own distress

By Dr. Stephanie Paulmeno, Public Health Education Specialist, Greenwich Department of Health

So many losses have been experienced by so many during the 2019 pandemic, which remains ongoing today. The pandemic is not yet behind us. There were losses of jobs, entire businesses, familiar hangouts and gathering places, as well as financial security and, many felt, the loss of personal liberties. All of those are potentially reversible, replaceable, or temporary in nature.

The sustained losses that affected so many of us, and that will endure because they touched our souls, were the losses of loved ones, friends, colleagues, and neighbors. As a nation we have already lost 992,302 people to COVID-19, and 10,615 of them came from Connecticut alone.

Our state deaths have slowed but as of 3-15-22, our 7-day moving average was still 15 deaths per day (https://ipv6.worldometers.info/coronavirus/usa/connecticut/).

The latest figure for COVID deaths in Greenwich was reported on March 4, 2022 to be 118. The First Selectman’s bi-weekly COVID reports, Community Connections from Fred ended on that day due to our town’s diminished COVID numbers.

As a clinical health and public health professional, a gerontologist, a case manager, and a contact tracer, I am keenly aware of the emotional toll COVID has had on people from many fields and walks of life who have lost those near and dear to them.

Many more have suffered from what is called secondary trauma, a reaction to the pain, suffering and loss of life around them even when they do not know the people involved. The Ukrainian tragedy that we are seeing daily is further compounding this enduring grief. During the pandemic, loss and grief reactions impacted front-line health and service providers, but also so many more who tended to be overlooked.

Our elderly were hard hit in case numbers, deaths, and isolation hardships. Volunteers and those in other service and compassionate relationships have also been profoundly impacted. Sometimes the loss of even a casual relationship can be deeply felt. Multiple and prolonged losses compound the reactions. Have you been scanning the obituaries during the pandemic to see if anyone you knew was now gone? Have you noticed people you would greet every day while walking your dog, which you are now no longer seeing and wondering if they are okay?

How about the relationships formed by community volunteers who shop for homebound people, deliver Meals on Wheels, or who make friendly visits through an agency or simply on their own? How about our shopkeepers and staff whom we see all the time? If you are anything like me, I make the time to get to know them, and when they are gone, I miss them. Strong attachments can and do occur in all these circumstances and these losses can feel profound. We have volunteers who’ve worked with people now lost due to COVID, who find it difficult to even drive down their streets. We have colleagues, volunteers, friends, family members and neighbors with sleep problems and other life disruptions due to what is really a post-traumatic stress reaction associated with loss, grief and fear. COVID could impact anyone of us at any time. If a loved one is unvaccinated, their chance of becoming ill and dying is many times greater than someone who is vaccinated which adds to our collective anxiety for those we love and cherish. Many don’t recognize the symptoms of the emotional reactions that can ensue, and they often don’t know how to help themselves of others. Are you aware that during COVID, the rates of depression, anxiety,

substance use and misuse increased; and that suicide attempts and deaths by suicide (in certain age and demographic groups) increased (https://www.kff.org/coronavirus-covid-19/issue-brief/the-implications-of-covid-19-for-mental-health-and-substance-use/ and https://www.cdc.gov/mmwr/volumes/71/wr/mm7108a5.htm)?

Health professionals have been being actively guided to be alert to impending signs of their own emotional distress, burnout, and compassion fatigue, as well as how to avail themselves of self-help and other resources; but what about our professional and good-neighbor volunteers and our non-health and social services essential workers? They too have struggled and continue to struggle with these same issues. More recently I read an article on the emotional toll COVID has taken on public health workers who’ve been dealing with contact tracing and the families in the communities who have been impacted by COVID disease and COVID losses (https://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2021/08/05/the-pandemic-has-devastated-the-mental-health-of-public-health-workers).

This year continuing education mandates were issued by the Connecticut Licensing Board for RN’s, LPNs, Nurses’ Aides, and Physicians’ Assistants, as well as for Physical and Occupational Therapists and Assistants, Behavior Analysts, Certified Community Health Workers, Emergency Medical Responders, Emergency Medical Technicians, & Emergency Medical Instructors. This came about because mental health crises in these groups have increased during the pandemic. The training mandate for these healthcare workers is on the topics of suicide, suicide assessment, prevention, and response; as well as PTSD, grief, and mental and behavioral health issues. At their request, I created two 1-hour programs for the Connecticut Nurses Association addressing this educational mandate, and which are available online on-demand by nurses and others as enduring programs at https://ctnurses-elearn.org

We should all know what resources are available if we or someone else is having an emotional problem:
• Suicide Prevention Lifeline Phone number: 1-800-273-TALK (8255)
• Emergency 3-digit phone lines:
• 211 for resources, information and referrals
• 811 for the new National Suicide Hotline number
• 911 for emergencies
• The crisis TEXT number: 741741To talk with a person about a mental health crisis or suicidal thinking: 800-273-TALK (& then press “1” for the Veterans’ Crisis Line)
• National Helpline: 1-800-622-HELP (4357)
• The HUB: Our Regional Behavioral Health Action Organization of the CT Department of Mental Health & Addiction Services (www.thehubct.org). The HUB’s Resource Guide in English & Spanish
https://www.thehubct.org/greenwich-to-westport
• You can also call
• Your Primary Care Provider (MD, APRN, PA)
• Your therapist if you have one
• Your clergy or faith leader
• A trusted friend or colleague